Prolactina y carcinoma de mama humano : estudio de la concentración basal y ritmo nictameral y relaciones con los niveles circulantes de antígeno carcino-embrionario

Tesis Univ. Complutense.Fac. de MedicinaTRUEProQuestpu

Prolactina y carcinoma de mama humano : estudio de la concentración basal y ritmo nictameral y relaciones con los niveles circulantes de antígeno carcino-embrionario

Tesis Univ. Complutense.Fac. de MedicinaTRUEProQuestpu

Chapter 9 - Physiology and Diseases of the Adrenal Glands in the Elderly

Age-related increases in ACTH and cortisol secretion, and decreases in DHEA/DHEAS, are unlikely to contribute significantly to the aging phenotype. In comparison, decreased renin secretion with age results in a 50% reduction in plasma aldosterone by age 70, and may explain the tendency for increased natriuresis, hyponatremia, and hyperkalemia in the elderly. Autoimmune adrenalitis is a relatively uncommon cause of adrenal insufficiency (AI) after age 60. The presentation of AI in older individuals is insidious and is associated with decreased functional capacity, increased risks for cardiovascular and infectious diseases, and more frequent adrenal crises. There are no specific age-related recommendations for diagnosis and replacement therapy with mineralocorticoids and glucocorticoids (GCs), although comorbidities, polypharmacy, and cognitive status should be assessed. Cushing’s syndrome in the elderly is most often due to excess GC treatment and, when sustained, can exert deleterious consequences on mood/affect, cognition, bone, muscle, visceral, fat, cardiometabolic function, and cutaneous fragility. Ectopic ACTH secretion is the commonest cause of endogenous hypercortisolemia in old age. There is insufficient information related to primary hyperaldosteronism and aging, both in regard to specific criteria for diagnostic screening and confirmation, and to clinical and treatment guidelines. Pheochromocytoma diagnosis in older adults is uncommon, although a quarter of all tumors are detected in patients over 60years of age, possibly due to blunted adrenergic manifestations in the elderly. Adrenal incidentaloma found are detected by imaging in up to 10% of older adults. Most are benign, nonfunctioning, adrenocortical, tumors. Endocrine function and malignancy potential should be evaluated as in younger adults. Adrenocortical cancer is a rare, aggressive disease, usually diagnosed between the 5th and 7th decades of life. Radical resection by open adrenalectomy is the only potential curative treatment. Minimally invasive, laparoscopic surgical techniques have greatly improved the safety of adrenal gland surgery, particularly in elderly patients

Larrad biliopancreatic diversion in Sprague-Dawley rats. Analysis of weight loss related to food intake

Se exponen los resultados obtenidos con la técnica de derivación biliopancreática de Larrad.Background Existing medical therapeutic strategies to achieve and maintain clinically significant weight loss in morbid obesity remain limited and the biliopancreatic diversion (BPD) is still the most effective among the bariatric surgical procedures. Our objective was to evaluate the weight and food intake after this procedure in a rat model. Methods Rats randomly underwent one of the following protocols (1) BPD (n=12) versus sham (n=12) with a follow-up period of 30 days and (2) BPD (n=4) versus pairfed (PF; n=4) with a follow-up period of 50 days. Under intraperitoneal anesthesia with ketamine–xilacine, a subcardinal corpo-antral gastrectomy was made, preserving the gastric fundus that was anastomosed to a jejunal limb after dissecting the proximal jejunum 5 cm below the ligament of Treitz to form the alimentary limb. The biliopancreatic limb was terminolaterally anastomosed to the distal ileum 5 cm above the ileocecal valve to form the common limb. Sham animals underwent only abdominal incision. Weight and food intake were measured every day. Results In protocol 1, after postoperative day 30, BPD rats exhibited a mean weight reduction of 17.9% while shams increased 12.4%. There was no difference in food intake adjusted per 100 g of body weight. In protocol 2, after postoperative day 50, BPD rats had a mean weight reduction of 22.6% and, despite increasing their caloric intake from a mean of 42.6 after 6 days to 65.8 kcal/day after 50 days, they kept a similar mean weight of 344.0 and340.2 g, respectively; on the contrary, PF rats exhibited a 30.8% body weight gain. Conclusions After the BPD, body weight is maintained independently of changes in food and energy intake.This work was supported by grants from the Spanish Ministry of Education, Xunta de Galicia, PGIDIT (02PXIB 2080 1PR) and the European Union (LSHM-CT-2003- 503041)